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Revision as of 14:49, 4 August 2011

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Cat scratch fever
ICD-10 A28.1
ICD-9 078.3
DiseasesDB 2173
eMedicine emerg/84 
MeSH D002372

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Cat scratch fever is a usually benign infectious disease caused by the intracellular parasite Bartonella. It is most commonly found in children 1-2 weeks following a cat scratch. It was first described in 1889 by Henri Parinaud. The cat was recognized as the vector of the disease in 1931 by Dr. Robert Debré.

The causative organism was first thought to be Afipia felis, but this was disproved by immunological studies demonstrating that cat scratch fever patients developed antibodies to two other organisms, Bartonella henselae and Bartonella clarridgeiae, which are rod-shaped Gram negative bacteria.

Kittens are more likely to carry the bacteria in their blood, and are therefore more likely to transmit the disease than are adult cats.

Ticks are also a major transmitter of this disease. It is often transmitted at the same time a human may get Lyme Disease. It is often missed when people are tested and diagnosed for Lyme Disease as the symptoms can be similar, such as fatigue, and headaches.

A simple blood test can test for the presence of antibodies for Bartonella. It can be quite common for someone to have Lyme Disease, Babesia and Bartonella from a single tick bite.

Other names

The condition has also been termed Cat-Scratch Adenitis, Cat-Scratch-Oculoglandular Syndrome, Debre's Syndrome, Debre-Mollaret Syndrome, Foshay-Mollaret Cat-Scratch Fever, Foshay-Mollaret syndrome, Foshay-Mollaret Cat-Scratch Fever Syndrome, Lymphadenitis-Regional Non-bacterial, Lymphoreticulosis-Benign Inoculation, maladie des griffes du chat, Parinaud oculoglandular disease, and Petzetakis' disease.

Signs and symptoms

Cat scratch fever presents with tender regional lymphadenopathy, sterile suppurative papules at the site of inoculation, slight fever, headache, chills, backache, abdominal pain, malaise, alteration of mental status, and convulsions. It may take 7 to 14 days, or as long as two months, before symptoms appear. Most cases are benign and self-limiting, but lymphadenopathy may persist for several months after other symptoms disappear. The prognosis is generally favorable. In temperate climates, most cases occur in fall and winter. The disease usually resolves spontaneously, with or without treatment, in one month. In immunocompromised patients more severe complications sometimes occur.

Treatment

Azithromycin, Ciprofloxacin, doxycycline, and multiple other antibiotics have been used successfully.

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